Endocrine Abstracts

INTRODUCTION: Disturbance in thyroid function following larygectomy usually manifests as hypothyroidism. Hyperthyroidism is not well recognized. We present a case of transient hyperthyroidism caused by laryngectomy. CASE STUDY: A 58-year-old man underwent total laryngectomy for laryngeal carcinoma. The surgery was not complicated. 3days following surgery, the patient was noted to have sinus tachycardia with a rate between 100 and 110. On the 7th postoperative day thyroid function test performed by the ENT team showed TSH of <0.008 micromol/L Normal 0.35-0.5) and free thyroxine of 43.4 pmol/L (Normal: 9.0-20.0). The patient denied any prior symptoms of hyperthyroidism. He has no family history of thyroid disease. Clinical examination revealed a clinically euthyroid patient other than a pulse rate of 100/minute. Peripheral manifestations of Graves' disease were not present. Thyroid function test done on the stored preoperative sample showed TSH was 0.585 mU/L. His postoperative period was complicated by operative wound infection and sinus formation. His discharge was delayed because of this. Thyroid peroxidase antibodies were normal at 7 IU/ml (Normal: 0-50) Radioiodine scan of thyroid done on the 18th postoperative showed there is profound generalized reduction in uptake consistent with thyroiditis. . He was observed without any medical intervention. Serial thyroid function tests confirmed normalization of serum concentrations of free T4 by the 16th and serum TSH by the 27th postoperative days respectively. CONCLUSION: Transient thyrotoxicosis is rare complication following neck surgery which can be managed conservatively.